Clinical outcomes of amniotic membrane loaded with5-FU PLGA nanoparticles in experimental trabeculectomy

AIM: To evaluate the effect of amniotic membrane loaded with 5-fluorouracil poly(lactic-co-glycolic acid)(PLGA) nanoparticles(5-FU-NPs) in the surgical outcomes of experimental trabeculectomy in rabbits.METHODS: Thirty-two New Zealand white rabbits were randomly categorized into four groups with 8 rabbits in each group. Group 1, the control group, performed traditional trabeculectomy without adjuvant treatment.While the experimental groups performed compound trabeculectomy with different implantations including amniotic membrane(group 2), 5-FU-NPs(group 3) and amniotic membrane loaded with 5-FU-NPs(group 4).Clinical evaluations including IOP measurement and filtration bleb analysis were performed in all groups postoperatively.RESULTS: There is no significant difference of mean IOP in all groups at first 7d after surgery. While at P14,mean IOPs of experimental group 2(9.8 ±2.1 mm Hg),groups 3(8.9 ±2.8 mm Hg) and group 4(7.6 ±2.3 mm Hg)were significantly reduced compared to control group(12.4 ±2.6 mm Hg; n =8, P 【0.05). At P21, mean IOPs of groups 3(11.7±3.2 mm Hg) and group 4(9.9±1.6 mm Hg)were significantly decreased compare to control group(17.9±1.6 mm Hg) and group 2(16.6 ±2.8 mm Hg; n =8,P 【0.05). At P28, mean IOPs of groups 3(13.8±3.3 mm Hg)and group 4(10.6 ±2.0 mm Hg) were also significantly reduced compare to control group(19.4±2.3 mm Hg) and group 2(18.5 ±2.4 mm Hg; n =8, P 【0.05). Meanwhile mean IOP of group 4 is significantly decreased compared to group 3 at P28(n =8, P 【0.05). Survival analysis of functional filtration blub in all groups revealed the longest survival time in group 4(24.9±5.1d) compared to that in group 3(20.6 ±4.3d), group 2(15.0 ±5.2d) and control group(10.1±5.7d).CONCLUSION: Amniotic membrane loaded with 5-FuNPs may function as an effective anti-scarring implant and provides improved long-term surgical outcomes for experimental trabeculectomy in rabbits.